Application. Community Health Excellence (CHE) Grant Program

Transcription

1 Cmmunity Health Excellence (CHE) Grant Prgram Applicatin A cmpleted applicatin must be submitted by July 30, 2017, and must include: A cmpleted Applicatin Cver Sheet and Narrative A cmpleted Itemized Budget Frm Letter f supprt frm prvider s CEO / CFO / Executive Directr Please submit all cmpleted applicatins in an electrnic frmat t: peter.mcgarry@pacificsurce.cm 136PRV

2 Cmmunity Health Excellence (CHE) Missin and Gals PacificSurce s Cmmunity Health Excellence (CHE) prgram was created t align with and supprt the missin f PacificSurce Health Plans: T prvide better health, better care, and better cst t the peple and cmmunities we serve. CHE grants seek: T create and expand an envirnment f cllabrative and innvative engagement between the PacificSurce Fundatin fr Health Imprvement and prviders wh share a visin fr better cmmunity health, better healthcare, and lwer healthcare csts. T fster an envirnment f cntinuus patient care imprvement amng prviders wh practice in the areas PacificSurce Health Plans serves. T elicit the diverse capabilities f prvider rganizatins in ways that make a significant psitive health impact fr unique patient ppulatins. Fr applicatin and budget frm, please see the CHE page n ur website: PacificSurce.cm/che-prgram Thank yu fr yur interest in PacificSurce s Cmmunity Health Excellence prgram! Cmmunity Health Excellence (CHE) Grant Prgram Applicatin Page 2 f 9

3 Requirements CHE Cre Criteria Successful CHE grant prpsals will be thse that will change the delivery f healthcare services in ways that prmte achievement f the Triple Aim (lwer csts, better patient experience, and higher quality f care) and imprve the health f the cmmunity. PacificSurce is interested in a wide range f innvative mdels and appraches, but currently has specific interest in prpsals that fcus n integratin f healthcare services (such as mental, physical, ral, and pharmacy), effective management f cmplex patients, and effective care transitins. Eligibility Parameters Healthcare prviders wh maintain a cntractual relatinship with PacificSurce Health Plans fr all lines f business applicable in the grant applicant s service area Healthcare prviders wh have significant annual revenue fr PacificSurce business Healthcare prviders whse prpsal demnstrates clear patient bjectives aligned with CHE prgram cre criteria and are supprted by measurable data. Please nte: CHE funds must benefit the grant applicant s patients regardless f their insurance cmpany. Successful prvider applicants frm a previus year are eligible t apply fr CHE funding fr a secnd year fr the same initiatives, but nly if they demnstrate: Significant pprtunities fr imprvement n the riginal initiative design that were nt realized in the first year New pprtunities fr care imprvement that were nt cntemplated r acted upn in the first year Successful grant applicants are limited t tw years f funding per initiative, and are nt eligible t apply fr a third year. Applicants must include: Prject narrative Detailed budget The name f a prject lead / spnsr wh will wrk with the Fundatin Letter f supprt frm their leadership team (CEO, CFO, r Executive Directr) Cmmunity Health Excellence (CHE) Grant Prgram Applicatin Page 3 f 9

4 Funding Parameters Funding is available fr expenses related t: Persnnel salaries Training Imprved patient care prcesses, including prgram develpment and designated clinic time Data cllectin and analysis Cmputer sftware, if integral and in supprt f initiative General supplies, in supprt f initiative Cmmunicatins materials, in supprt f initiative Patient care nt therwise reimbursable by gvernment r private insurance cverage Funding is nt available fr expenses related t: Building r infrastructure remdeling Medical equipment r medical supplies Cmputer hardware r electrnic medical recrds (EMRs) Cnsulting services, lng term studies Studies r preliminary planning fr initiatives nt therwise resurced by anther rganizatin Any third year f a CHE initiative that has been funded fr the prir tw years Applicatin Review: PacificSurce s independent physician reviewers will review and scre f applicatins. All funding decisins will be made by PacificSurce at their sle discretin and subject t funding availability. Timing f Funding and Reprts: Half f the funding fr an accepted CHE initiative will be made at the nset f the prject, and the remaining half will be made upn the submissin f a six-mnth prgress reprt. The funding recipient is additinally required t submit a final-year prgress reprt. Payments: Funding will be made t the tax ID number used by the prvider fr PacificSurce Health Plans claims payments. End-f-Year Cllabratin Cnference: Recipients are expected t participate in shared experiences and learning with ther CHE funding recipients at a cllabratin cnference rganized by PacificSurce. Cmmunity Health Excellence (CHE) Grant Prgram Applicatin Page 4 f 9

5 Applicatin Cver Sheet Name f rganizatin: Organizatin Tax ID#: Address: City, State, Zip: Payment address: (if different) Prject title: Prject spnsr: Organizatin CEO/CFO/ Executive Directr submitting Letter f Supprt: Address (if different): Phne: Funding requested: Funding categry: Prject summary: Cmmunity Health Excellence (CHE) Grant Prgram Applicatin Page 5 f 9

6 Applicatin Narrative (There is a 10-page limit. In additin, yu may include tw ptinal pieces f supplemental materials (such as research articles, wrk plan, and s n). 1. Organizatinal Backgrund Please list the: Organizatin lcatin Number f prviders/full-time equivalents (fr ambulatry care prjects) Number f beds (fr hspital care prjects) Organizatinal missin statement Team members r prject participants, including their rle in the rganizatin. Indicate the rganizatin s key prject spnsr. 2. Prject Descriptin A. Ambulatry Care Initiatives Present an verview f the prject and hw it addresses elements f the ambulatry care patient categries and ambulatry care prgram bjectives (see belw). Please include: What the prject is trying t accmplish What changes are being prpsed by the prject Wh the targeted patient ppulatin is Hw the prject will benefit the lives f the patient ppulatin The emerging best practices and/r evidence-based guidelines upn which the prject is based Similar existing cllabratins r initiatives The unique traits and capabilities f the rganizatin that will be emplyed by this prject Hw different clinicians, hspitals, r ther members f the cmmunity will learn abut yur prject Ambulatry care patient categries: Newbrns Children, including thse with asthma, diabetes, r ther chrnic cnditins Pregnant wmen Adults with diabetes, asthma, cngestive heart failure (CHF), chrnic bstructive pulmnary disease (COPD), r ther chrnic cnditins Adults in need f mental health r chemical dependency services Adults in need f preventative care services Adults in need f end-f-life care Cmmunity Health Excellence (CHE) Grant Prgram Applicatin Page 6 f 9

7 Examples f ptential ambulatry care prpsals: Imprved access t utpatient care Imprved chrnic cnditin management, as prvided in clinician ffice r thrugh selfmanagement Imprved cmmunicatin, crdinatin, and/r integratin f utpatient care between prviders Intrductin f multidisciplinary care mdels Delivery f evidence-based medicine Use f Patient Decisin Aides (PDAs) Imprved pregnancy / prenatal care Imprved management f cmplex cnditins Imprved preventive care Increased patient satisfactin Increased utilizatin f care in the apprpriate setting Reduced utilizatin f unnecessary emergency rm visits Reduced utilizatin f unnecessary hspitalizatins B. Prject Descriptin Hspital Care Initiatives Present an verview f the prject and hw it addresses elements f the hspital care prgram bjectives (see belw). Please include: What the prject is trying t accmplish What changes are being prpsed by the prject Wh the targeted patient ppulatin is Hw the prject will benefit the lives f the patient ppulatin The emerging best practices and/r evidence-based guidelines upn which the prject is based Similar existing cllabratins r initiatives The unique traits and capabilities f the rganizatin that will be emplyed by this prject Hw different clinicians, hspitals, r ther members f the cmmunity will learn abut yur prject Examples f ptential hspital prpsals Infectin reductin/preventin (surgical site, central line, MRSA, and s n) Never Event preventin as defined by Centers fr Medicare & Medicaid Services (CMS) Reduced surgical cmplicatins /errrs Evidence-based care fr cardiac/circulatry cnditins, such as CHF, mycardial infarctin, strke, and ther cnditins Reductin f harm frm high-alert medicatins, dsing errrs, allergic reactins, r adverse drug events/interactins Reductin f bed sres/pressure ulcers Increased patient satisfactin Cmmunity Health Excellence (CHE) Grant Prgram Applicatin Page 7 f 9

8 Imprved crdinatin r integratin f hspital care with cmmunity prviders Reductin f unnecessary readmissins t the hspital Imprved transitin f care fr patients upn discharge frm inpatient care settings 3. Measurements What are the measurements that will indicate the prject bjectives have been met? Will they measure prcess r utcme? Will they be based n any best-practice r evidence-based care guidelines? What methd and tls will be used t cllect data? Wh will cllect the data? What dependencies (cnsultants, utside staff, systems, planned system upgrades, and s n) will data cllectin rely n? 4. Timeline Prvide detail n a ne-year timeline fr the prject, including key steps, phases, and bjectives. Prvide detail n hw data will be cmpiled fr mid-year and end-f-year prgress reprts. 5. Sustainability Prvide infrmatin n any plans fr sustaining the prject beynd the ne-year prject cycle. 6. Organizatinal Strategic Plan Describe hw yur prject fits int yur rganizatin s strategic r lng-range plans. 7. Letter f Supprt Include a letter f supprt frm yur rganizatin s Chief Executive Officer, Executive Directr, r Chief Financial Officer. 8. Itemized Budget Include a cmpleted CHE Itemized Budget Frm. 9. Success Dependencies What is the ne element in yur applicatin that yu anticipate will cntribute the mst t yur initiative s success? What is the ne element (r missing element) that may cause the initiative t nt meet its gals? Cmmunity Health Excellence (CHE) Grant Prgram Applicatin Page 8 f 9

9 Timeline Engagements with prviders interested in CHE prgram... Thrugh July, 2017 Applicatin deadline... July 30, 2017 Applicatin decisins by the PacificSurce Fundatin... Octber 7, 2017 (apprximate) First CHE payments... Nvember 1, 2017 Onging prgress reprts... Every 8 weeks (apprximate) Mid-year prgress reprts due, with data... May, 2018 Secnd CHE payments... May, 2018 End-f-year prgress reprts due, with data... Nvember, 2018 Cllabratin cnference with presentatins... Nvember, 2018 Cmmunity Health Excellence (CHE) Grant Prgram Applicatin Page 9 f 9